As more of us opt away from the traditional practice of optometry, which includes dispensary provisions, there still remains a number of independent optometric physicians who provide optical care to their patients. Today's independent eyecare professionals, especially young students just entering practice, have spent the majority of their didactic and clinical educational experience (including internships, externships and residencies) learning how to diagnose and treat most eye disorders and diseases.

In reality, many of these bright people don't understand what's involved with having a dispensary and can't fathom that it's another available stream of revenue. Many of these new O.D.s have abandoned "the optical experience" to pursue their own brand of 21st century eyecare delivery in which they rely almost completely on just examining and treating patients who have disease. Also, a number of private practice optometrists think that having their own lab is too much of a bother. This article will prove otherwise.

Financially speaking

The financial landscape for the independent, non-surgical eyecare professional is significantly different from the financial landscape for the same type practitioner of past years. Operational costs have continued to exceed the annual cost of living and decreases in reimbursement from Medicare and or insurances have resulted in relatively flat income levels. In addition, many offices that have dispensing capabilities haven't considered improving the overall profitability that the laboratory portion of a dispensary can afford them.

Unless your office's patients are solely
VSP, Medicaid or another vision care plan that forces you to use the plan's own lab for spectacle fabrication, you should seriously consider installing an in-office lens casting system and a great quality patternless edger. That's exactly what I did in my office, and it really paid off.

(The numbers included in this table and in the text of this article are based on Dr. Gindoff's experience with Optical Dynamics' Q-2100R casting system and are provided for the purposes of example only. Optometric Management encourages you to use your practice's actual numbers when investigating the purchase or lease of equipment.)

Plugging in the numbers

Now let's take a look at the cost of casting and edging in-office compared with the cost of sending this work out. I'm going to round off the numbers for the sake of simplicity, but in my office, we were paying about $70 for a pair of uncut quality progressive lenses; about $30 a pair for high-index, single vision lenses; $35 to $40 a pair for high-index, flat-top bifocals; and about $15 a pair for "regular" flat-top bifocals from our local laboratory. It wasn't uncommon to see a monthly lab bill break the $8,000 to $10,000 mark.

With our in-office lens casting system, we could produce a pair of excellent quality lenses for less than $17 a pair. That means an excellent pair of thin progressives (because of the 1.56 index of refraction of the casting system's material) cost about as much as a pair of regular bifocals. If the patient's prescription was >±2.00, then the benefit of a thinner lens was quite apparent.

Looking at reason

Let's say you have a "typical" office with a dispensary, but you send out all of your work to a lab because you:

don't want to be bothered with the process

don't think you can afford the equipment

don't want to hire someone to perform the service

don't care to make any more money by trying something else.

The advantages for having an in-office lens casting system extend beyond cost savings and include the following:

Superb lens quality. The lens material has an inherent UV blocker and the lenses are significantly thinner and clearer.

Incredibly small footplate: Including the patternless edger, you can probably do in-office casting and edging in six linear feet.

Other than an occasional "beep" signal, the manufacture of lenses is almost silent and new patternless edgers are also quiet.

No lens/blank inventory. The entire inventory is in a bottle!

You can make a pair of top-quality, progressive lenses (start to finish) within 30 minutes.

The major eyeglass chains learned this years ago: The faster you can get the patient his eyeglasses, the faster you get your money. Say goodbye to offending some patients by asking for a deposit while you manufacture their glasses.

Increased profitability. I'll explain in more detail below.

For the sake of this article, we'll say that you use the same lab that I used so the numbers I mentioned earlier for progressive lenses are still valid. Let's also say that your gross is well below $500,000 each year and that you prescribe no more than five pairs of glasses each day, five days each week from walk ins. Therefore, you're ordering 100 pairs of lenses from your lab each month.

Let's break things down even further. You're only prescribing one progressive each day (20 each month) and good quality, higher-index (lighter, thinner) lenses for 80% of the other jobs. We'll assume that your lab charges you the same amount as our old lab did for different lens types (but we'll assume that you don't edge lenses, so the lab is charging you, on average, an extra $7.50 each pair for that service [Editor's note: Edging fees may run $15/pair or higher]). Therefore, your hard cost in a month equals about $4,430 for the lenses (see "Money Spent on Outside Labs").

Is An In-Office Lab Right for You?

How do your lab costs compare to what your costs would be with an in-office system? If you're not sure, then check out the following Web sites, which give cost analyses and economic views on the
issue.

Based on this number, you're paying an outside lab $53,160 each year, or about $4,430 each month, in material costs. Without much analysis, consider how much it would cost in just materials if you used your own in-office lens casting system:

We'll assume it costs you about $17 a pair for any type of progressive or high-quality pair you'd create. Because you're manufacturing the lenses, you would also now have a good quality, patternless edger and would therefore save the money spent in edging ($7.50); additionally, it would be cheaper for you to use a local lab for the standard pair blanks and have your new, in-house lab edge those.

Therefore, your material cost is now $17 x 80 ($1,360/month) and $15 x 20 ($300/month) for a total of $1,660/month. Let's throw in an extra $600 for edging and other incidental costs for a $2,260 total monthly cost. So even with these heavily skewed numbers, you can still save more than $2,000 each month and you can now offer immediate service and provide excellent quality to your patients.

This is one of the few technologies that I can think of that instantly pays for itself from its first use. The potential savings are enormous to any office that does a modicum of spectacle dispensing. Our laboratory bills were a bit more than this hypothetical example and we more than halved the bill in the first month of using our in-office lens casting system. This translates into thousands of dollars that can help make up for an office's rising costs.

Involving your staff

It takes about three days to teach someone who has never had any optical experience and probably less than one day to teach an optician. Depending on the size (volume) of your optical, you'd generally only need to train one person. It's not a bad idea to have someone else around who knows how to perform the tasks in the event the other person is sick or on vacation. It's so easy, that you could easily give this task to a high school student. Plus, it takes less than two minutes to edge lenses on a patternless edger.

Don't turn down a profit

New practitioners who have heavy debt burdens should look to this new technology as a quick means to extricate yourselves from your loans. Somewhere between three and four pairs of lenses each day could help you to completely break even. Everything beyond that is profit. "Profit" -- oh what a lovely word to an M.B.A.

Dr. Gindoff is an
adjunct associate clinical professor of optometry at Nova Southeastern University College of Optometry. A frequent lecturer and author, he earned an M.B.A. with highest honors in 1998 from the University of Sarasota.

Tracking Down In-Office Casting and Edging Equipment

Interested in buying a lens casting or edging system? See what these companies have to offer. For up-to-date equipment information, OM recommends you contact the company directly.

NATIONAL
OPTRONICS, INC.National Optronics offers lens processing equipment, which is designed primarily around the company's patented dry-cutting technology. This dry edging uses a carbide steel blade to cut a lens to size and shape.
www.nationaloptronics.com

OPTICAL DYNAMICSOffers a lens fabrication system, the Q-2100, that's computer-controlled and can create single and multifocal lenses, including aspheric and photochromic designs.
www.opticaldynamics.com